Fort Payne Urgent Care, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

FORT PAYNE URGENT CARE, LLC

Practice address

2605 Gault Ave N Ste 200
Fort Payne, AL 35967-3700

Phone

(256) 979-1990

Fax

(356) 979-1992

NPI assigned

May 6, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Luiz Juan, APNNPI 1912446337

Title

Owner

Phone

(256) 979-1990

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25908/brand/1/csg/1/fhir/r4

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Luiz Juan, CRNP

  • Family Nurse Practitioner
  • Fort Payne, AL
  • NPI 1912446337

  Acute Care

  Medicare reassignment Care Compare group NPD Authorized official
• Kimberly Kay Crow, CRNP

  • Family Nurse Practitioner
  • Rainsville, AL
  • NPI 1710120969
  Medicare reassignment Care Compare group NPD
• Micah Miranda Hilyer, NP

  • Family Nurse Practitioner
  • Fort Payne, AL
  • NPI 1124678628
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1346986015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FOREST AVE NW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359672054",
            "telephone_number": "256-979-1990",
            "fax_number": "256-979-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 GAULT AVE N STE 200",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359673700",
            "telephone_number": "256-979-1990",
            "fax_number": "356-979-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT PAYNE URGENT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-06",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "JUAN",
        "authorized_official_first_name": "LUIZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-979-1990",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fort Payne MRI LLC
• Fort Payne Pediatrics LLC
• Fort Payne Pediatrics, LLC
• Fort Payne Pharmacy LLC
• Fort Payne RHC Corp
• Janna Foshee, MS, CCC-SLP
• Ora Gwendolyn Foster, LCSW
• Tonya Leigh Fox, CRNA
• Frederico Fernandez, MD. PC
• Katelyn Freeman, MS CCC/SLP

• Family Nurse Practitioner in Fort Payne, AL
• Providers in Fort Payne, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.